Objective: This study examined the association between 5-aminolevulinic acid (5-ALA) and glucose tolerance. Design: A double blinded, randomized prospective parallel-group comparison study. Setting: Participants were recruited from the community in Honolulu, Hawaii, using radio and TV ads, and at community events. Participants: One hundred fi fty-four males and females ages 40-70 years, with evidence of prediabetes: hemoglobin A1c (HbA1c) 5.8%-7.0% at the screening visit. Intervention: Participants were randomized equally to one of three study groups: (1) low dose 5-ALA supplement (15 mg capsule); (2) high dose 5-ALA (50 mg capsule); and (3) control (placebo capsule of identical size and color). Main outcome measures: HbA1c and 2 hours post-oral glucose tolerance test (OGTT) glucose levels. Results: Among individuals taking 5-ALA supplements for 12 weeks, 2 hours post-OGTT glucose levels declined signifi cantly compared to those not taking the supplement ( p = 0.02). The relationships were stronger among those with baseline glucose intolerance, or 2 hours post-OGTT glucose measurements greater than 140 mg/dL ( p = 0.005 and p = 0.02 for the low and high dose group, respectively). Similar trends were observed for HbA1c but results were of borderline signifi cance ( p = 0.07). No untoward effects were reported. Conclusions: Further studies are indicated. The potential benefi ts of 5-ALA dietary supplementation are affi rmed by this investigation.

Background We evaluated the perceived success of recruitment and retention protocols for Native Hawaiian/Pacific Islander/Filipino populations. These three groups were found to have a significantly higher incidence of health disparities than the general population. Training applications of selected vignettes were also generated. Methods Focus groups and questionnaires were used to achieve the objective: Identification of themes related to facilitators and deterrents to participation in clinical trials in these populations. This mixed methods approach evaluated promotional materials preferred. Responses to animated videos and vignettes with actors regarding clinical research participation were analyzed. Participants included adults of Hawaiian/Pacific Islander or Filipino ethnicity. Analysis included grounded theory methods, such as constant comparative techniques. Results The results revealed that attention to the following categories is essential: culturally sensitive knowledge, attitudes, and beliefs related to individuals, families and communities. Discussion These themes are recommended as the structure for future interventions to improve participation and retention within these groups.

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